循证医学绪论.pdfVIP

《循证医学》 Evidence-Based Medicine, EBM 绪论 仇玉兰 上海交通大学医学院公共卫生学院 QIU Yu-lan Shanghai Jiao Tong University School Of Medicine QIU Yu-lan Shanghai Jiao Tong University School Of Medicine QIU Yu-lan Shanghai Jiao Tong University School Of Medicine Evidence Based Medicine：循证 医学用于针对个体病人的临床实践 Evidence Based Healthcare：用 于对成组病人或群体作出医疗卫生 决策 QIU Yu-lan Shanghai Jiao Tong University School Of Medicine QIU Yu-lan Shanghai Jiao Tong University School Of Medicine QIU Yu-lan Shanghai Jiao Tong University School Of Medicine 循证医学的概念： David Sackett 和Muir Gray：循证医 学是有意识地、明确地、审慎地利用 现有最好的证据制定关于个体病人的 诊治方案。实施循证医学意味着医生 要参酌最好的研究证据、临床经验和 病人的意见。 QIU Yu-lan Shanghai Jiao Tong University School Of Medicine QIU Yu-lan Shanghai Jiao Tong University School Of Medicine QIU Yu-lan Shanghai Jiao Tong University School Of Medicine 循证医学与传统医学在处理临床问题时 的区别： 传统医学解决临床问题的方法： （1）阅读教科书 （2 ）根据自己的经验和生物学知识 （3 ）请教专家 （4 ）阅读有关文献 QIU Yu-lan Shanghai Jiao Tong University School Of Medicine QIU Yu-lan Shanghai Jiao Tong University School Of Medicine QIU Yu-lan Shanghai Jiao Tong University School Of Medicine 循证医学解决临床问题时认为： （1）慎重、准确和明智地应用当前所能 获得的最好的研究依据 （2 ）医生的个人专业技能和多年临床经 验 （3 ）病人的价值和愿望 QIU Yu-lan Shanghai Jiao Tong University School Of Medicine QIU Yu-lan Shanghai Jiao Tong University School Of Medicine QIU Yu-lan Shanghai Jiao Tong University School Of Medicine 循证医学的发展背景： 一、医学模式的转变 二、医疗资源的相对不足 三、概率论及新兴的统计学方法对临床 决策的作用 由于人类记忆的谬误，外科医生倾 向于更多地记住他们成功的案例而 不是失败的案例 QIU Yu-lan Shanghai Jiao Tong University School Of Medicine QIU Yu-lan Shanghai Jiao Tong University School Of Medicine QIU Yu-lan Shanghai Jiao Tong University School Of Medicine 放血治疗伤寒： 例数 例数 平均生存时间